Menu Expand
The Emotional Labour of Nursing Revisited

The Emotional Labour of Nursing Revisited

Pam Smith


Additional Information

Book Details


As nurses become responsible for increasingly technical service delivery, has
the profession lost its focus on the emotional and human aspects of the role?
Do care and compassion remain at the heart of contemporary nursing practice?
In this major reworking of a classic text, respected author Pam Smith emphasizes
the continued relevance of emotional labour within the modern healthcare
context. Revisiting her original findings in light of fresh theoretical perspectives
and data drawn from her own new research studies, Smith explores the ways
in which the experience of learning nursing and caring is changing in the twentyfirst
A vivid example of the significance of nursing's evidence base, this timely new
? addresses the most emotionally challenging aspects of the nursing role,
including encountering death and dying on the ward;
? examines the impact of race, age, gender and violence in providing patientcentred
care;? interrogates the importance of the role of practice educators and mentors in
practice settings.
An inspiring text for the next generation of nurses, The Emotional Labour of
Nursing Revisited is an essential read for anyone interested in the contemporary
challenges of keeping the whole person at the centre of their practice.
PAM SMITHis Professor of Nurse Education and Head of Nursing Studies in the School of Health in Social Science at the University of Edinburgh, UK. As the General Nursing Council (GNC) Trust Endowed Chair in Nurse Education, she held the post of Director of the Centre for Research in Nursing and Midwifery Education at the University of Surrey, UK from 2002 to 2009.

This is an excellent text, timely and much needed in health care today. It was such a pleasure to read a very important contribution to nursing knowledge and I'm sure that so many nurses and health care workers would benefit from reading it. I suggest it should be core reading on all health care programmes, especially nursing.' - Dr D.M. Mazhindu, Senior Research Fellow, Faculty of Health and Applied Social Science, Liverpool John Moores University, UK

''An extremely well presented text which offers a great breadth of discussion, drawn from a robust evidence base. This is a book that I would imagine students and post registered staff referring back to time and time again.' - Brigid Purcell, Senior Lecturer, University of Huddersfield, UK

""This book has many [highlights]…but it has an important message to pass on - emotional labour takes its toll…At times it is uncomfortable and difficult reading but thought provoking and necessary…Smith raises some salient points regarding how we teach and support nurses, the importance ward structures and supportive environments play in encouraging our workforce." - Nursing Times

Table of Contents

Section Title Page Action Price
Cover Cover
Half-Title i
Dedication ii
Title iii
Copyright iv
Contents v
List of Illustrations ix
Acknowledgements x
Preface xi
Foreword xiv
1 Introduction 1
‘The little things’ 1
What is care? 10
The emotional labour of care 12
Emotional labour and emotional intelligence 15
Nursing and care 16
The body–mind dichotomy 18
The politics of care 20
Emotional labour costs 23
Everybody’s ideal 26
The nurse as emotional labourer 27
2 Putting their toe in the water: selecting, testing and expecting nurses to care 30
Research subjects, settings and methods 30
The 1984 study 30
The need for a new study in the 2000s 31
Who train as nurses? 32
1984–1985 32
2006–2008 32
Ward learning environment questionnaire respondents 32
Demographic characteristics 32
Educational qualifi cations 33
Programme and year of study 33
‘Too posh to wash’ 34
Recruitment and retention 35
The job prospectus 35
Selection procedures 39
1984–1985 39
2006–2008 42
Standing up in the NHS environment 44
Methods of testing and assessment to ensure students are ‘up to standard’ 48
The role of the mentor/assessor 48
Meeting with the mentor/assessor in practice to review progress 49
Mentor/assessor’s assessment of and statement of achievement 49
In Nightingale’s image 51
1980s style 51
Perspectives for the 2000s 53
Summary 54
3 Nothing is really said about care: defining nursing knowledge 56
The impact of policy on nurse education and the nursing workforce 57
Caring not nursing, working not learning 58
The content of nurse training 64
City Hospital in the 1980s 64
The NHS in the 2000s 66
The curriculum in four case study sites 67
Linking theory and practice 68
Mentoring systems and training 70
Supernumerary status 70
Student support 70
Implementing the ‘Living Curriculum’ 71
The 1980s 71
Nursing process: philosophy, conceptual device or work method? 72
The 2000s 72
Affective/psychosocial nursing and learning to do emotional labour 73
Patient–nurse perceptions: fi rst-year students 73
Critical incidents: third-year students 75
The psychiatric nursing module 76
Informal training for people work: feeling rules and emotion management 77
Learning to communicate and emotion management: patients’ views Patients’ views: 2000 79
Summary 81
The 1980s 81
The 2000s 82
4 You learn from what’s wrong with the patient: defining nursing work 84
You learn from what’s wrong with the patient: how medical specialities legitimize nursing work 85
Recognizing emotion work 91
The 1980s 91
The 2000s 93
When the feelings don’t fi t 94
There are some patients you’d rather nurse than others: issues of age, gender and race – then and now 99
When emotional labour is the work: the case of violent patients 102
The 1980s 102
The 2000s 103
Dispelling the stereotypes: issues of race 104
The 1980s 104
The 2000s 105
Summary 106
5 The ward sister and the infrastructure of emotion work: making it visible on the ward – from ward sister to ward manager and the role of the mentor 108
Everybody’s ideal: characteristics of ward sisters and nurses 109
Producing and reproducing emotional labour in the ward 112
Reproducing emotional labour, management styles and the nursing process 114
The ward learning environment in 2006–2008 119
Managers and mentors 119
From ward sister to ward manager: who sets the emotional tone? 124
The changing infrastructure of emotional labour and learning in the 2000s 126
Summary 130
6 Death and dying in hospital: the ultimate emotional labour 132
Introduction 132
Defi ning death and dying in hospitals in the 1980s 132
Feelings about death and dying 134
Death’s unpredictability 135
Packaging death 136
‘You knew exactly what to do’: a death well managed 137
The technical and emotional labour of death 138
Death and bereavement 140
The role of the hierarchy in managing death 144
Facing death and dying in the 2000s 144
Death and dying – still the ultimate emotional labour 147
Students’ stories in the 2000s 149
‘No one to help when your fi rst patient dies’ 149
‘Talking and cups of tea’ 150
‘I’d never done care work before’ 151
New ways of packaging death 152
Caring not nursing 153
Summary 154
7 The caring trajectory: caring styles and capacity over time 156
The student nurse trajectory in the 1980s 158
First-year students: ‘so good to have around’ 159
Third-year students: ‘the blues time’ 163
Refl ections for the 2000s 164
Personal emotion work 164
Being thrown in at the deep end 165
Caring factors 170
Ward management styles: recognizing o repressing individuality 170
Ward management styles: recognizing the student’s learning role 175
Personal support 176
The caring-learning relationship and emotional labour 177
Emotional labour: styles and strategies 178
The 1980s 178
The 2000s 181
8 Conclusions 183
Concepts of care and emotional labour 183
At what cost care? 187
The future of nursing theory and practice 189
Agenda for Change 189
Modernising nursing careers 190
Maintaining morale and wellbeing 191
Emotions, experiential learning and new knowledge 192
The disappearing ward sister 195
Death and dying in hospital: still the ultimate emotional labour 196
Facilitating caring trajectories 197
The effects of emotional care on patient outcomes 199
Notes 204
References 214
Index 225